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• W4387053078 abstract "The effects of hypohydration on thermoregulatory function are well known; heat illness prevention literature highlights inadequate fluid intake as a major risk factor. A previous report showed that 17% of EHS casualties were hypohydrated (Carter, 2005). However, that study relied on ICD-9 coding and the low incidence may reflect incomplete charting/recording of secondary or tertiary diagnoses such as hypohydration. PURPOSE: The purpose of this study was to examine the association between hypohydration (determined by urine specific gravity (USG) and/or plasma osmolality) and heat illness in a cohort presenting to the Martin Army Community Hospital (MACH) Emergency Department (ED). METHODS: Active duty service members who were transported to MACH and subsequently diagnosed with heat exhaustion (HE), heat injury (HI) or exertional heat stroke (EHS) were eligible for inclusion. Volunteers provided written informed consent & completed a demographic questionnaire; relevant laboratory data were retrieved from the electronic medical record. An individual was considered hypohydrated if USG >1.020 or serum osmolality was >290 mOsm/kg, based on blood and urine samples obtained within 15-min of arrival to the ED. RESULTS: Hydration data were available for 55 cases (51 male, 4 female, age 22 ± 4 yrs, height 175 ± 7 cm, weight 78.9 ± 12.3 kg). Of those, USG was determined in 49 cases, OSM in 19 cases, and both in 13 cases. Using USG as the biomarker, 13/25 HE, 2/6 HI and 4/18 EHS casualties were hypohydrated. When serum OSM was used as the biomarker, 1 EHS casualty was considered hypohydrated; all others were normally hydrated. When both biomarkers were available for a given case, there was agreement in 10/13 cases. CONCLUSIONS: Hydration status varied by biomarker, with plasma OSM less likely to indicate hypohydration. In this cohort, hypohydration was proportionally more prevalent in HE and HI vs. EHS. These data suggest that heat illness prevention strategies that emphasize the role of hydration status may overlook the influence of other risk factors, such as acclimatization status, aerobic fitness, body composition and individual behavior/motivation to perform. Supported by USAMRDC; author views not official U.S. Army or DoD policy." @default.
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• W4387053078 date "2023-09-01" @default.
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• W4387053078 title "Association Between Hydration Status And Incidence Of Exertional Heat Illness In A Military Cohort" @default.
• W4387053078 doi "https://doi.org/10.1249/01.mss.0000988940.38571.08" @default.
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